Circulating tumor cells: advances in isolation and analysis, and challenges for clinical applications

Pharmacol Ther. 2014 Feb;141(2):209-21. doi: 10.1016/j.pharmthera.2013.10.004. Epub 2013 Oct 14.

Abstract

Circulating tumor cells (CTCs) are rare cancer cells released from tumors into the bloodstream that are thought to have a key role in cancer metastasis. The presence of CTCs has been associated with worse prognosis in several major cancer types, including breast, prostate and colorectal cancer. There is considerable interest in CTC research and technologies for their potential use as cancer biomarkers that may enhance cancer diagnosis and prognosis, facilitate drug development, and improve the treatment of cancer patients. This review provides an update on recent progress in CTC isolation and molecular characterization technologies. Furthermore, the review covers significant advances and limitations in the clinical applications of CTC-based assays for cancer prognosis, response to anti-cancer therapies, and exploratory studies in biomarkers predictive of sensitivity and resistance to cancer therapies.

Keywords: AR; CK; CTC; Cancer biomarker; Circulating tumor cells; DEP; EGFR; EMT; ER; EpCAM; FDA; FISH; HER2; IF; ISET; PR; PSA; PSMA; Predictive biomarker; Prognostic biomarker; RT-PCR; US Food and Drug Administration; androgen receptor; circulating tumor cell; cytokeratin; dielectrophoresis; epidermal growth factor receptor; epithelial cell adhesion molecule; epithelial–mesenchymal transition; estrogen receptor; fluorescence in situ hybridization; human epidermal growth factor receptor 2; immunofluorescence; isolation by size of epithelial tumor cells technique; plasma tumor DNA; progesterone receptor; prostate specific antigen; prostate-specific membrane antigen; ptDNA; reverse transcription polymerase chain reaction.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Biomarkers, Tumor
  • Humans
  • Neoplasms / diagnosis*
  • Neoplastic Cells, Circulating*
  • Prognosis

Substances

  • Biomarkers, Tumor